Nervous and mental diseases . the cremastericreflex is usually exaggerated and theplantar may be increased, but the toe-sign of Babinski is never present. Ifthe muscles waste, fibrillar twitching isfrequently observed, and there is pare-sis or paralysis. In the rare spasmodiccases already mentioned, in which theplexus or cord is involved, the entirelimb may be drawn up in a painful andprotracted spasm upon the slightestcutaneous irritation, even by a breathof air or the contact of of the vasomotor andtrophic functions of the nerve in severe and protracted cases renders the
Nervous and mental diseases . the cremastericreflex is usually exaggerated and theplantar may be increased, but the toe-sign of Babinski is never present. Ifthe muscles waste, fibrillar twitching isfrequently observed, and there is pare-sis or paralysis. In the rare spasmodiccases already mentioned, in which theplexus or cord is involved, the entirelimb may be drawn up in a painful andprotracted spasm upon the slightestcutaneous irritation, even by a breathof air or the contact of of the vasomotor andtrophic functions of the nerve in severe and protracted cases renders thelimb livid in color, cold to the touch, with a temperature reduced severaldegrees. Barre^ states that even in moderate and recent cases thelower external area of the leg will be found cooler than the correspondingsurface of the sound limb. The perspiration is usually reduced, butmay be increased, and the dermal structures frequently suffer, as in iEdin. Med. Jour., No. 9, 1901. 2 Jour. Amer. Med. Assoc, p. 1037, April, Fig. 114.—Sciatica of long duration onright side; wasting of buttock and leg, somecontracture with tendency to stand on toe,elevation of hip, and scoliosis. LESIONS OF SPECIAL SPINAL NERVES. 313 neuritis elsewhere. Scaliness, herpetiform eruptions, erythema, andacne sometimes appear, and perforating ulcer has been muscles waste and show the reaction of degeneration to wasting is most noticable in the leg and buttock, but the short ex-tensor of the toes is the most frequently involved, and this too early andin mild cases (Barre). The enlarged nerve may sometimes be increase of cutaneous fat may mask the muscular wasting. A double sciatic neuritis is almost invariably due to spinal disease orpelvic disorder, to the suspicion of which it should always give rise. Diagnosis.—The diagnosis of a sciatic neuritis is not ordinarily diffi-cult. It is based on persistent pain and upon the presence of the ana-tomically locat
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